Connie Singleton told her mother a "therapeutic fib," and it's breaking Connie's heart. Connie was brought up to tell the truth, whatever the consequences. She believes her pastor father must be rolling in his grave. Was Connie wrong to lie to her mother?

Mom, who has mid-stage dementia, wouldn't take one of her very important medications. That day Connie had the presence of mind to not argue with her mother. Instead, she casually said, "It's your vitamin C, Mom. They were out of your regular brand." Mom took her pill without further argument.

Tom takes his father to the "Men's Club" twice a week. This excursion to an adult day care is something his father always enjoys. He stubbornly refused to go to another "day care," but as a lifelong Lion, he associates this "club" with the Lion's Club meetings he used to attend. He feels purposeful when he goes to his "Club." He felt infantalized when he went (once) to "day care."

John regularly wants to know where his wife is. She passed away several years ago. Rather than tell him (again) that she has died, his family has learned to say, "She's gone with Aunt Thalia." Aunt Thalia also died a while back, but John has forgotten. While they aren't exactly lying, John's family is giving him a slightly twisted version of the truth that he can understand, and that won't give him pain and anguish.

Therapeutic fibbing, or telling little white lies (fiblets) is a way of saying things in a way that protects people with dementia from pain or increased anxiety.

Many caregivers feel that therapeutic fibs are simply lies with a politically correct label. They were brought up to tell the truth, especially to their parents. They feel guilty  about using the technique.

In all honesty, there is no way to avoid doing "something" that may be painful in these situations. As caregivers, we must consider the relative damage that telling the truth will do, versus the consequences of telling a fiblet. If the pain we do to our elders by always telling the plain, unvarnished truth is greater than the small tug at our conscience created by telling a therapeutic lie, then most caregivers choose to spare their elders.

If it helps, try to remember that "therapeutic" means "healing or curative," and a "fib" is a "trivial, insignificant lie" (according to the dictionary). Without the use of a fiblet or two, Connie's mother would be at a greatly increased risk of having a stroke. Tom's father would be sleeping in his recliner all day at home, becoming ever more disengaged and confused. John would hear the news about his wife's death several times every day, and he would be freshly devastated each and every time.

All three of their caregivers individually came to the conclusion that the little fibs they tell to protect their elders with dementia are less cruel than telling the unvarnished truth would be.

Note: Therapeutic fibs are sometimes confused with "redirection" and "validation therapy." If your confused senior asked where his deceased wife was, family and caregivers might try to redirect him by saying something like, "You must really miss her," and then adding, "Where is that picture of Mom and Allan? Can you help me find it?" This is validation that he is probably missing his wife, and redirection to a different activity, which also sometimes works, but isn't the same thing as a therapeutic fib.